Our client went to an emergency room in a hospital located in the suburbs of Chicago. He was admitted to the hospital with a known history of a duodenal duplication cyst or diverticulum. He had stomach pain and had been vomiting. A CT Scan of the abdomen was interpreted to reveal an enlargement of this duplication cyst or possible pancreatic pseudocyst. A gastroenterologist diagnosed our client with acute pancreatitis due to a duodenal duplication cyst.
The gastroenterologist sought a consult from the surgery service and a general surgeon saw our client. A repeat CT scan with contrast was ordered by the surgeon and the interpretation was for a long-standing duodenal duplication cyst. The surgeon recommended a Whipple procedure (pancreaticduodenectomy) = an operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. It was our expert’s position that recommending an invasive surgical procedure in a patient with acute pancreatitis and performing a Whipple procedure was a deviation from accepted standards of care.
The Whipple procedure recommended and carried out by two surgeons is a highly complex procedure which carries a high risk of complications. It should only be contemplated when a patient is suffering from a severe stricture or a potential malignancy at the ampula of the pancreas – where the pancreatic duct and bile duct join to drain into the duodenum. Neither of these circumstances were present in this case. Additionally, surgery should not have been performed with ongoing active pancreatitis. The minimum standard of care would require the pancreatitis to resolve and then evaluate for an elective surgical correction o this duodenal duplication cyst.
In our client, if surgery was ultimately decided upon once the pancreatitis resolved, resection of the duodenal cyst wall with Roux-en-Y reconstruction is the established surgery of choice. More importantly there was no documentation of the informed consent process, risks, benefits, and most important no documentation of the intra-operative decision making, which a more extensive resection was performed without indication.
The deviations from the standard of care by the surgeons caused post-operative complications and significant injuries in our client, too many to be listed in this article. Had the surgeons complied with accepted standards of care, our client, more likely than not, would have recovered with far less complications.
We filed a medical malpractice lawsuit in Chicago, Cook County, Illinois, alleging (amongst other things) that the two general surgeons were negligent in that they:
- Failed to accurately diagnose our client’s condition of ill-being;
- Failed to appropriately treat our client’s condition of ill-being;
- Failed to interpret the diagnostic studies of our client’ abdomen and pelvis;
- Performed a Whipple procedure surgery when it was not appropriate to do so;
- Failed to perform the correct surgery on our client; and
- Were otherwise careless and negligent in the care and treatment of our client.
The case was aggressively defended by lawyers for the two surgeons and the hospital they worked at. Shortly before trial was to begin, the defense lawyers informed the trial judge that they would like to discuss settlement, that the insurance company for the doctors gave them authority to resolve this matter. This was news to us as we were told many times while this case was pending, that there would be no offers of settlement. The case settled for a substantial, though confidential amount. Our client felt extremely proud that he was able to hold these two surgeons accountable, and he will have the necessary funds to live the rest of his life in comfort.
